What does it mean to have multiple chronic conditions?

In this article, this means having two or more of high blood pressure, diabetes, and high cholesterol at the same time. Diagnostic criteria and management goals differ by condition, so review test results with your health care team.

Which should you manage first: blood pressure, blood sugar, or cholesterol?

Rather than treating the three numbers as competing priorities, address the issue that poses the greatest immediate risk first. If a result is severely elevated or you also have cardiovascular or kidney disease, work promptly with your care team to set treatment goals while improving nutrition, physical activity, and smoking habits together.

If I take multiple medications, won't it put a strain on my liver or kidneys?

When taking multiple medications, regularly review their benefits and side effects. Stopping medications on your own may be more dangerous. Bring a list of your prescription and over-the-counter medications and supplements to appointments so your care team can determine which tests are needed.

Which home records can help guide my care?

For blood pressure, record the date, time, systolic and diastolic readings, and pulse. If you check your blood sugar, record whether it was fasting or after a meal. Tracking your weight, medications, activity, and specific symptoms can also help guide care.

How to Manage Multiple Chronic Conditions

An integrated guide to managing high blood pressure, diabetes, and high cholesterol

Before reading this article

If high blood pressure, elevated blood sugar, and abnormal cholesterol results all appear on your health screening, you may not know what to address first. It can be tempting to dismiss each result when it is only slightly above the reference range.

However, a South Korean analysis found that one in five adults has two or more of the following: high blood pressure, diabetes, and high cholesterol. Managing multiple chronic conditions together is therefore an important health concern.

Complex chronic diseases are not a problem that only affects people of a certain age. Weight gain, lack of exercise, a diet high in salty foods and refined carbohydrates, smoking, lack of sleep, and family history may increase the risk. However, there are ample opportunities to lower your risk and improve your health by managing your lifestyle and treatment together.

What is a complex chronic disease?

Multiple chronic conditions refers to having two or more chronic diseases at the same time. Although chronic conditions cover a wide range, South Korean health data often examine high blood pressure, diabetes, and high cholesterol together.

Although these three diseases appear to occur independently of each other, they share many common risk factors.

| disease | Mainly checked indicators | Key risks of not managing | |------|------|------| | high blood pressure | blood pressure readings | Heart disease, stroke, decreased kidney function | | diabetes | Fasting blood sugar and glycated hemoglobin | Eye, nerve, kidney, blood vessel complications | | High cholesterol | LDL cholesterol, triglycerides, and other values | Atherosclerosis, heart attack, stroke |

When multiple diseases overlap, the risk of cardiovascular disease can increase compared to when there is only one risk factor, and treatment, medication, and test schedules become complicated. Therefore, an approach that looks at the overall risk is needed rather than managing diseases separately.

Recent South Korean data

According to data published by the Korea Disease Control and Prevention Agency in December 2025 and revised in February 2026, deaths due to non-infectious diseases in 2024 were **282,716**, accounting for **78.8%** of all deaths. In the same year, non-infectious disease medical expenses were approximately **90 trillion won**, **80.3%** of total medical expenses.

Another Korea Disease Control and Prevention Agency analysis found that one in five South Korean adults has two or more of the following: high blood pressure, diabetes, and high cholesterol. These figures show that multiple chronic conditions are a common public health concern in South Korea.

The important thing is not to be anxious about numbers, but to check your risk factors and test results and create a management plan.

1. First, organize your health status in one page

Managing complex chronic diseases begins with not scattering test results. Collect health checkup results and hospital test reports from the past year and organize them so you can see the following items at a glance.

Blood pressure: systolic/diastolic blood pressure, date and location of measurement
Blood sugar: fasting blood sugar, glycated hemoglobin, and postprandial blood sugar if necessary.
Lipids: LDL cholesterol, HDL cholesterol, triglycerides
Weight and waist circumference
Kidney function and urine test results
Prescription medications, over-the-counter medications, and supplements you currently take

Standards for test results may vary depending on the individual's age, presence of cardiovascular disease, kidney function, pregnancy, etc. Don't just copy someone else's goal numbers; check with your doctor about your management goals.

2. Do not set priorities only based on the ‘highest number’

When managing complex chronic conditions, it can be easy to think that you can simply start with the highest number and work your way down. However, treatment priorities take into account not only severity but also the following factors:

Have you already had a heart attack, angina, or stroke?
Do you have diabetes and kidney disease together?
Do you smoke?
What are your family history, age, and weight?
What medications you are taking and what the risks of side effects are.

For example, even if the LDL cholesterol level is the same, treatment goals may be different for people who have already suffered from cardiovascular disease and those who have not. Conversely, even if the number is not very high, active management may be necessary if multiple risk factors overlap.

3. Diet considering the three diseases together

For high blood pressure, it is important to eat a diet that reduces sodium, and for diabetes, it is important to control the type and amount of carbohydrates. For hypercholesterolemia, reducing saturated fat and trans fat and increasing dietary fiber are helpful.

The basic dietary principles considering the three diseases together are as follows.

Foods to increase

Freshly cooked vegetables and seaweed
Vegetable proteins such as beans, tofu, and lentils
Appropriate amounts of whole grains such as brown rice, barley, and oats
Fish and skinless chicken
Unsweetened dairy products and small amounts of unsalted nuts

Foods to reduce

Foods high in sodium such as soups, stews, salted seafood, and pickled vegetables
Carbonated drinks, sweetened coffee, fruit juice
Snacks high in refined carbohydrates such as white bread, cookies, and rice cakes
Foods high in saturated fat, such as pork belly, bacon, sausage, butter, etc.
Excessive consumption of fried and delivered food

You don't need to completely cut out rice or ban all fruits and carbohydrates. Eating vegetables and protein at every meal and adjusting the amount of rice, bread, and noodles according to your activity level is a way to sustain your health for a long time.

4. Start by dividing your exercise into short chunks.

Many people cannot start exercising because of the pressure of having to exercise for a long time at a time. Start with short activities, such as walking for 10 to 15 minutes after a meal, and once you get used to it, increase your activity throughout the week.

Regularly engage in aerobic exercise such as brisk walking, cycling, and swimming.
Maintain muscle mass by adding strength training about twice a week.
If you sit for more than an hour, get up and move lightly.
Check for changes in blood sugar or dizziness before and after exercise

If you have heart disease, severe high blood pressure, complications from diabetes, or have not exercised for a long time, it is safe to consult your healthcare provider before increasing the intensity of your exercise. If you experience chest pain, severe shortness of breath, or a feeling like you may faint, you should stop exercising and seek medical attention.

5. Manage medicine ‘safely’ rather than ‘too much’

If you have multiple diseases, the type of medicine may increase. If you arbitrarily stop taking the medication or change the time of taking it just because you have too many medications, your blood pressure, blood sugar, and cholesterol may worsen again.

To ensure safe medication use, please do the following:

Bring a list of your current medications to appointments and pharmacy visits.
Tell your care team about medications prescribed by other clinicians.
Tell your care team if you also take supplements or herbal products.
Record any new symptoms, such as dizziness, suspected hypoglycemia, swelling, or severe muscle pain.
Check your next treatment and prescription schedule before you run out of medication.

The effects and side effects of medications vary from person to person. Even if your blood pressure or blood sugar levels have improved, the decision to reduce or stop taking medication should be made together with your medical team after checking the test results.

6. Home records can improve the quality of your care

A single reading at a medical appointment cannot show the full picture. Taking consistent measurements at home and recording the results can help guide treatment decisions.

Blood pressure recording

Sit comfortably and rest for about five minutes before measuring. Avoid checking immediately after caffeine, smoking, or exercise. Take two readings one to two minutes apart at about the same time each day and record both. Ask a healthcare professional or pharmacist to review your technique and device use.

Blood sugar records

If you measure your blood sugar, write down whether it is fasting or how many hours after a meal. If you also record what you eat, exercise, and take medications, it's easy to understand how certain lifestyle habits affect your blood sugar.

Record your weight and symptoms

Check your weight regularly under the same conditions, and if you experience symptoms such as edema, shortness of breath, chest discomfort, dizziness, or suspected hypoglycemia, write down the date and situation.

Questions to prepare for your appointment

You can manage various diseases efficiently by writing down the following questions and checking them at the doctor's office.

What are my current goals for blood pressure, blood sugar, and cholesterol?
Which of the inspection values needs to be improved first?
When and how long should I take the medicine I am taking?
Can I take my medication and supplements together?
When should I get the next blood test and complication test?
What should I be especially careful about with exercise and eating?

If you receive care at multiple locations, share prescriptions and test results from each one. This gives your care team a complete view of your care plan and can help reduce duplicate prescriptions and omissions.

Symptoms that require immediate medical attention

If the following symptoms suddenly appear in people with multiple chronic conditions, they should not wait to seek emergency medical care:

Chest pain, cold sweat, severe breathing difficulties
Loss of strength in one side of the face, arm, or leg
Slurred speech or sudden difficulty seeing
Blurred consciousness or convulsions
Symptoms suspected of severe hypoglycemia do not improve

Do not judge whether it is an emergency based on blood pressure or blood sugar levels alone. If you have unusual or severe symptoms, seek help immediately.

Don’t change all at once, start with a one-month plan

In managing complex chronic diseases, maintaining small changes for a long time is more important than following a perfect diet every day.

Week 1

Record the food, drinks, snacks you eat, and your blood pressure at home and work. Before you change, you need to know your current habits.

Second week

Replace sugary drinks with unsweetened drinks and reduce your broth intake. Start walking 10 minutes every day.

Third week

Include vegetables and protein at each meal, and choose an appropriate amount of rice, bread, or noodles.

Week 4

Review your blood pressure and blood sugar records and dietary changes, and share them with your care team at your next appointment. If a goal was difficult to follow, treat it as something to adjust next month rather than a failure.

Key Summary

Complex chronic diseases are conditions where high blood pressure, diabetes, hypercholesterolemia, etc. appear simultaneously.
It was analyzed that 1 in 5 adults has two or more major chronic diseases.
Organize test results on one page and confirm individual management goals with your care team.
Reduce sodium, sweet drinks, refined carbohydrates, and saturated fat, and eat a balanced diet of vegetables, beans, fish, and whole grains.
Do not stop medication on your own; tell your care team about all prescription medications, over-the-counter medications, and supplements.
Consistently recording your blood pressure, blood sugar, weight, and symptoms will help you get treatment and adjust your lifestyle habits.
Seek medical attention immediately for emergency symptoms such as chest pain, paralysis, slurred speech, or decreased consciousness.

Checklist

[ ] Have you organized your recent blood pressure, blood sugar, and cholesterol test results in one place?
[ ] Do you have a list of all the medications and supplements you currently take?
[ ] Do you measure and record your blood pressure or blood sugar at home?
[ ] Are you reducing your intake of soup, processed foods, and sweet drinks?
[ ] Do you walk or do strength training several times a week?
[ ] Have you written down questions to ask at the next treatment in advance?

References

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This article is for general health information purposes only and is not a substitute for medical diagnosis or prescription.